RACF residents avoid hospital with virtual ED consultations

Phillip De Bondi

South Australian Virtual Care Service (SAVCS) - SA Health



The South Australian Virtual Care Service (SAVCS) was established in December 2021, offering the South Australian Ambulance Service (SAAS) direct access to Emergency Department (ED) trained clinicians via a virtual consult. The intent was to avoid inappropriate transfers to the state's emergency department by effectively bringing the senior clinical staff to the patient via video conferencing.

SAVCS data demonstrated that approximately 16% of all referrals to the service from SAAS came from Residential Aged Care Facilities (RACF). It was observed that this cohort often had significant delays with waiting for transport to the hospital, waiting at the hospital, and waiting to be transported back home. Evidence from the 2019 Royal Commission into Aged Care noted that residents do not always achieve good outcomes by attending a hospital and that thousands of inappropriate ‘000’ calls come from RACF.

SAVCS saw an opportunity to provide direct access to the SA Virtual Care Service senior clinicians for residents residing in aged care to improve the timeliness of care delivery and reduce the need for residents to move to access care and to better support RACF staff. The virtual consult allows people who know the resident best to discuss the scenario with SAVCS’s urgent care staff directly. Virtual consults allow staff, family, and friends to be included on the call regardless of their geographical location.

Service Development Timeline

  • June 2022: A co-design workshop was held with key stakeholders, including SAAS, Primary Health Networks, Aged Care providers, and SAVCS, to develop the pathway.

  • July 2022: Engaged with a Pilot Provider to roll out the pathway to their sites.

  • August 2022: Engaged with Early Adopter Providers to ensure the initial success of the pathway was not unique to the Pilot Provider.

  • October 2022: Opened the SAVCS pathway to all RACF across SA.


At the time of writing, SAVCS has had 1,318 virtual consults with RACF residents across South Australia. 84% of RACF residents will have their care managed with alternate pathways to a traditional emergency department, including offering care in place (66%) of residence without needing to be transported at all. The consulting time for a SAVCS consult is 43 minutes (median) and is far less than the traditional pathway of involving SAAS, transport to ED and time to access, and assessment of bricks-and-mortar ED while avoiding the risk of hospital-acquired complications. SAVCS is safe, with no significant incidents since inception.


We are progressing with the expansion of the pathway to get more RACF to utilise the service. Whilst over 80% of aged care providers have registered to use SAVCS, 40% remain to utilise the service. SAVCS plans to improve this with continued engagement and co-design with our RACF partners. SAVCS is working with partners on opportunities to understand and further support upskilling of RACF nurses in gaining experience in acute assessment. The direct interaction between onsite referring clinicians and SAVCS specialist clinicians is a unique offering to SAVCS.

For more information, please contact: Phillip De Bondi at

Royal Commission into Aged Care Quality and Safety. Final report: Care, dignity and respect - volume 1 summary and recommendations Canberra, ACT: Commonwealth of Australia; 2021 [cited 2023 Aug 20]. Available from:

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*The views and opinions expressed in Knowledge Blogs are those of the authors and do not necessarily reflect those of ARIIA, Flinders University and/or the Australian Government Department of Health and Aged Care.